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A structured approach to shoulder pathologies in overhead athletes

Classification and key considerations for successful treatment

Strukturierter Ansatz bei Schultererkrankungen von Überkopfsportlern

Klassifikation und wesentliche Überlegungen für eine erfolgreiche Therapie

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Abstract

Shoulder pain is frequently seen in overhead athletes. The diagnosis and treatment are often difficult because of multiple factors. However, this variable group of patients can be classified into three main groups according to the requirements of their specific sports: (1) injuries caused by internal impingement (posterosuperior impingement and anterosuperior impingement); (2) injuries caused by acquired macro- or micro-traumatic instability with secondary internal impingement; and (3) injuries caused by rotator cuff-associated pain due to hyperlaxity/multidirectional instability. A structured approach to the evaluation of these athletes is presented and specific key factors are suggested to define the best treatment option.

Zusammenfassung

Schulterschmerzen treten häufig bei Überkopfsportlern auf. Diagnose und Behandlung sind aufgrund mehrerer Faktoren oft schwierig. Diese variable Patientengruppe kann jedoch aufgrund der Anforderungen ihrer spezifischen Sportarten in 3 wesentliche Gruppen eingeteilt werden: (1) Verletzungen durch internes Impingement (posterosuperiores Impingement und anterosuperiores Impingement); (2) Verletzungen durch erworbene makro- oder mikrotraumatische Instabilität mit sekundärem internem Impingement und (3) Verletzungen durch Schmerzen in Zusammenhang mit der Rotatorenmanschette aufgrund von Hyperlaxität/multidirektionaler Instabilität. Ein strukturierter Ansatz zur Bewertung dieser Sportler wird vorgestellt, und spezifische Schlüsselfaktoren werden vorgeschlagen, um die beste Behandlungsoption festzulegen.

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Author information

Authors and Affiliations

  1. Department of Shoulder Surgery, ATOS Orthoparc Clinic, Aachener Str. 1021 B, 50858, Cologne, Germany

    Knut Beitzel MD, M.A.

  2. Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany

    Lukas N. Muench MD &  Daniel P. Berthold MD

  3. Department of Orthopaedic Surgery, University of Colorado, Denver, USA

    Eric McCarty MD &  Daniel P. Berthold MD

Authors
  1. Knut Beitzel MD, M.A.
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  2. Lukas N. Muench MD
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  3. Eric McCarty MD
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  4. Daniel P. Berthold MD
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Corresponding author

Correspondence to Knut Beitzel MD, M.A..

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Conflict of interest

K. Beitzel is a consultant for Arthrex. E. McCarty has received research support from Arthrex, Biomet, Breg, Mitek, Ossur, Smith & Nephew, and Stryker; education payments from Gemini Mountain; consulting fees from Zimmer and Medical Device Business Services; speaking fees from Arthrex; and royalties from Elsevier and Zimmer Biomet. L.N. Muench and D.P. Berthold declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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Beitzel, K., Muench, L.N., McCarty, E. et al. A structured approach to shoulder pathologies in overhead athletes. Obere Extremität 17, 21–26 (2022). https://doi.org/10.1007/s11678-021-00676-3

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  • DOI: https://doi.org/10.1007/s11678-021-00676-3

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